A young, Honduran woman stepped into the dusty school room. She sat down at the wooden school desk, the arms of the chair wrapped snuggly around her waist. A breeze blew, but only to swirl hot heat. Smoke from the burning trash wafted its way in through the windows. Jen, a certified nurse midwife student, asked her, “How many pregnancies have you had? How many births? How many abortions or miscarriages?” She continued on with standard women’s health questions. The woman had broad shoulders and a kind smile. Before her pap and pelvic exam, she told us of her shoulders, how they ached with a heavy pain. All the women in the village carried large jugs of water atop their heads for long distances. They did it with a smile and slight forward bend. We gave her ibuprofen to calm the pain, then directed her to the “exam room.”
Early in the morning Jen, Lucia, Khadra and I worked fastidiously to set up the women’s health room. We toted around metal tri-folding screens then duct taped old shower curtains to the rods for privacy. We gathered rocks to stabilize the screens, and roped cloth around the front to create an entryway. We used a square object wrapped in a Depends diaper to assist in lifting the woman’s bottom up in lieu of an exam table and stirrups. We taped paper over the window screens with holes to shield one-hundred peeking first-grade eyes. And we waited, for women exactly like her, who came in need of a women’s health exam.
“Señora, listas?” I asked. “Si,” she answered. I stepped inside the walls of the draped curtains with Khadra. She sat atop the folding table, draped in an oversized blue disposable robe, a scene not unfamiliar to millions of American women. But, very much about this exam room was unfamiliar. Children’s books, whose spines were covered in dust, scattered about. One rusted fan squeaked in the corner. Sweat dripped from all of our brows in the 105-degree heat, and sliding my pap headlamp down onto my face. And here, with this Honduran woman, stood two American women preparing to perform a wholly intimate, and sometimes intimidating exam. She sat on the table in her robe, her arms crossed tightly over her knees, tucked into her chest. The kind, warm woman we greeted at triage now seemed timid. Rightfully so. I slowed down, looked at her, and smiled, then said, “Me llamo Julia. Yo soy una enfermada de los estados unidos.” She nodded. I instructed her to place the box-shaped object beneath her lower back and slide to the bottom of the table. Khadra looked down at her toes, with dirt caked beneath each toenail, as they curled up tensely. She put her hand on one of her feet and said to me, “She is very tense. It is difficult to do an exam when their body is tense.” I put one hand on her knee, and softly said, “Relajé (relax),”. I looked in her eyes, softly told her to relax, and to breathe. “Respire.” Just keep breathing. We finished the exam swiftly and let her know we would step out of the room for her to put on her clothes.
When she emerged, her warm, kind smile returned and she thanked us. I did not feel there was much to thank me for. I peered out the glass window as she walked out and looked at the woman in the village walking with water atop their heads. The children lined up, giggling and pushing. The stray dogs scratching themselves and roosters pecking. I remember when I served in the United States Peace Corps in Thailand, we used a phrase, “Same same, but different.” It meant that although there were many cultural or environmental similarities, it was also vastly different. Today took me back to that notion, that although some similarities exist, we are outsiders, traveling into well-worn villages. The dust and smoke, the physical labor and piece-mealed healthcare is their normal. For merely one moment in time, it was our new normal, but forever theirs. And I realized, the woman in the exam room wasn’t the only one tense, but me, too, as I immersed myself wholly into rural Honduran culture and the healthcare that is accessible to them. Today I was grateful for my team of nurse practitioners and nurse practitioner students, and all of those who assisted us to bring skilled healthcare to that village. I felt grateful for the privilege to travel to Honduras as part of The Ohio State University and the College of Nursing. The world, with its gritty, harsh realities, punctuated by a multitude of kindness, compassion, and joy, never ceases to amaze me. And as I struggled to put it all together in my head, I breathe and remind myself, “relajé.”